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Query: UMLS:C0038358 (gastric ulcer)
 5,179 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We have presented a retrospective study of the surgical management of 299 patients bleeding from duodenal ulcer, gastric ulcer or gastritis. The overall mortality rate was 15%-5% for elective and 25% for emergency operations. The mortality increased with age and reached 50% for emergency operations in patients over the age of 70. Patients with low admission haemoglobin values, who had episodes of hypovolemic shock or who required immediate transfusions were also at risk. A Billroth I gastric resection proved to be the safest operative procedure. Based on our results, we are supporting a program calculated to reduce the mortality attending gastroduodenal bleeding, especially in those patients requiring an emergency operation. The basic principles of this program are constant observation, prompt diagnosis and early surgical intervention.
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PMID:Surgical management of gastroduodenal haemorrhage. 59 95

Fiberoptic endoscopy of the upper gastrointestinal tract was performed on 53 patients without incident, ranging in age between two months and 18 years, of whom 35 were out patients at the time of examination. Of 27 patients with recurrent abdominal pain and normal upper gastrointestinal series, eight had abnormal findings at endoscopy: a duodenal ulcer in four, a gastric ulcer in two and duodenitis in two. Of 18 patients with hematemesis and/or melena, esophageal varices were demonstrated both by endoscopy and x-ray in two, gastric ulcer by endoscopy in three and x-ray in one, duodenal ulcer by endoscopy in three and by x-ray in two, esophagitis by endoscopy only in one patient, erosive gastritis by endoscopy in five and by x-ray in two and duodenitis by endoscopy in three and by x-ray in two. Of the remaining eight patients with abnormal x-rays findings and other symptomatology, endoscopy demonstrated foreign bodies in two (coins, esophagus and stomach), duodenitis in two, a gastric ulcer in one, a duodenal ulcer in one and normal examination in two. The data indicate that fiberoptic endoscopy significantly improves diagnostic accuracy in the evaluation of disorders of the upper gastrointestinal tract in children and is a safe and effective procedure in ambulatory pediatric patients.
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PMID:Fiberoptic endoscopy of the gastrointestinal tract in infants and children. I. Upper endoscopy in 53 children. 60 92

The incidence and distribution of chronic gastritis, chronicatrophic gastritis and epithelial dysplasia I-III have been investigated in 50 resected stomachs of patients suffering from duodenal ulcer, gastric ulcer, early or advanced gastric cancer. Only in gastric cancer epithelial dysplasia III has been frequently observed, particularly in the neighbourhood of gastric cancer. Distribution of chronic-atrophic gastritis was similar to the distribution of dysplasia I and II. These mucosal lesions were detectable with the same frequency in patients with or without gastric cancer.
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PMID:[Histo-topography of gastric mucosa changes in benign and malignant stomach diseases]. 61 13

The development of morphological changes in the body mucosa after partial gastrectomy for ulcer disease according to Billroth I and II was studied early (within 3 years) and late (10-24 years) postoperatively with gastroscopy and forceps biopsies. The morphological findings in the body mucosa of the operation specimens and biopsies from the stomas were compared. The effect of time, ulcer disease, operation procedure, sex, and age was studied. In duodenal ulcer patients, with significantly less pronounced inflammatory mucosal changes in the operation specimen, partial gastrectomy caused acute and chronic gastritis to the same degree as seen in gastric ulcer patients within 3 years postoperatively. Duodenal ulcer patients also developed mucosal atrophy, cystic dilatation of the gastric glands, and intestinal metaplasia by time to an extent not significantly different from what was found in gastric ulcer patients. No correlation could be found between the mucosal changes and factors like age, sex, or operation procedure. Mucosal atrophy, chronic gastritis, and intestinal metaplasia are regarded as possible features of malignant transformation. If this concept is true, our findings may explain why stump carcinoma is frequently reported with the same incidence independent of preoperative ulcer disease or anastomotic procedure.
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PMID:The development of mucosal changes after gastric surgery for ulcer disease. 63 61

This study provides a retrospective comparative analysis of results in 90 women patients who underwent three different elective operations for intractable duodenal ulcer disease. Group I (30 patients) underwent truncal vagotomy/antrectomy (TV + A); group II (30 patients) gastric selective vagotomy/pyloroplasty (GSV + P); and Group III proximal gastric vagotomy (PGV). There were no operative deaths among the 90 patients. No patient after TV + A has developed a recurrent ulcer. Two recurrent ulcers developed after GSV + P, and one gastric ulcer occurred after PGV. Dumping, diarrhea, and reflux gastritis were lower after PGV than with TV + A and GSV + P. Follow-up studies have been from six months to ten years. The clinical results among the three groups of women patients compare favorably with results obtained in a recent prospective randomized study using the identical operative procedures in three groups of men patients operated upon for intractability. There was no statistically significant difference between women and men after similar operative procedures, but the postgastrectomy sequelae were less after PGV in both women and men patients.
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PMID:Results of elective duodenal ulcer surgery in women: comparison of truncal vagotomy and antrectomy, gastric selective vagotomy and pyloroplasty, proximal gastric vagotomy. 64 96

Clinical indications, operative findings, technical details and pathological studies in 228 Billroth-I-Pean gastrict resections for gastric ulcer, are represented in detail. 186 of these patients could be followed up with a maximum of 18 years: 8.6% had troubles after meals, 8.6% gastritis of the remaining stump, 5.9% a small stomach syndrome and 0.5% a reflux oesophagitis. But no one of them had to be reoperated nor for functional troubles, nor for recurrent ulceration. According to the Visick classification the following results have been obtained: V. 1:75.3%, V. 2:13.4%, V. 3:7.5% and V.4:3.7%.
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PMID:[Should the B-I gastric resection no longer be used? Results of 228 cases (author's transl)]. 65 41

The occurrence of gastritis in antral and body mucosa is compared in an Icelandic and a Danish group of patients with gastric ulcer, duodenal ulcer, and X-ray negative dyspepsia. In all 93 Icelandic and 88 Danish patients were examined. All signs of antral gastritis were more frequent in Icelandic than in Danish patients, but only the incidence of superficial inflammation and decreased mucus content in surface and crypt epithelium differed significantly. In body mucosa pseudopyloric metaplasia was more frequent in Iceland and occurred equally freqeuntly in all three diseases. A statistically significant correlation was found between macroscopic gastritis and occurrence of antral superficial inflammation and between smoking and superficial inflammation and decreased mucus content in the pyloric biopsy specimen. The presence of histological gastritis was not correlated to the intake of alcohol and salicylic acid, nor to the presence of pain at the time of investigation.
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PMID:A prospective comparative study of clinical and pathological characteristics in Icelandic and Danish patients with gastric ulcer, duodenal ulcer, and X-ray negative dyspepsia. II. Histological results. 67 62

The author examined the cytographs of gastritis, polyps and ulcers according to the materials of the prophylactic examination of a dispensary group, comprising 265 patients at high risk for gastric cancer. The differential features of the cytographs were examined in the cases in which the complex gastrogical investigation showed the concidence in the results of gastrofiberscopy, gastrobiopsy and cytological tests. The differential cytologic diagnosis of polyps and gastric ulcer is found to be possible in the presence of papillary structures in the first case, and in the second--a great variety of stromal infiltrate cell structure with the obligatory presence of lymphocytes, plasmatic cells, histiocytic elements, eosinophilous and neutrophilous leucoctyes. The differential cytological diagnosis between different histological forms of gastritis needs further studies.
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PMID:[Use of the cytological method in benign pathological processes of the stomach (based on data from the prophylactic examination of persons with a high risk of cancer morbidity)]. 67 23

The patient with gastric ulcer (GU) has abnormal reflux of bile-containing duodenal contents into the stomach. Antral gastritis is prominently associated with GU and is more extensive with severe reflux and with ulcer chronicity and probably when bile salts are accompanied by other constituents of duodenal fluids. Smoking is significantly associated with GU, and it produces reflux in normal subjects and in patients with duodenal ulcer, which in turn is commonly associated with GU. Reflux has not been shown to precede either the gastritis or the gastric ulcer and probably persists despite ulcer healing. The pyloric spincter in the patient with GU probably contracts subnormally to endogenous or exogenous secretin or CCK. This can be explained by associated hypergastrinemia since antral acidification improves the response. Because the pylorus may be usually open, abnormal reflux may be related as much or more to disturbances of other gastroduodenal functions known to control the movement of chyme through what may be a relatively passive pyloric zone. Speculation from animal models implicates bile reflux in aspirin-induced and shock-related gastric ulceration and assigns to bile a possible explanation, in part at least, for the apparent therapeutic efficacy of a carbenoxalone derivative and an antipepsin agent. Similar speculation warrants a search in the patient with GU for abnormalities of gastroduodenal peristalsis-related electric activity and for impaired release of secretin, possibly from antral cells of production. Possible abnormal purinergic inhibition of the gastric fundus and pylorus also warrants further study.
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PMID:The incompetent pyloric sphincter. Bile and mucosal ulceration. 77 71

Idiopathic chronic gastritis is an autoimmune disease and the cause of this gastritis probably act through a final common immunologic pathway. Specific gastric antibodies are diagnostic of this gastritis and the tissue of the gastric mucosa is characterized by infiltrations of mononuclear cells damaging the glandular parenchyma with concomitant loss of gastric secretory function. With suitable predisposing factors operating, the patient with simple chronic gastritis can have pernicious anemia develop. Chronic gastritis is frequently associated with chronic gastric ulcer and carcinoma of the stomach but not with duodenal ulcer. Chronic gastritis clinically presents with vague dyspeptic symptoms. Females are more commonly affected than males and the incidence rises with advancing age. Treatment of chronic gastritis is supportive in nature and also similar to the treatment of other autoimmune diseases. The author has suggested a new treatment of duodenal ulcer whereby the patients are immunized against mucosal antigen with a view to induction of chronic gastritis. The resulting biochemical damage of the parietal cells will produce hypochlorhydria.
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PMID:Idiopathic chronic gastritis. 79 68


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